Initially, with the transformation of sleep architecture, cycles are shorter and characterised by more frequent awakenings, until the moment when micro-awakenings are no longer perceptible.
Sleep-related problems during childhood can have a significant impact on both children and their caregivers. The distinction between what is physiological (normal) and what may represent a health concern, together with the individual dynamics of each family and the demands of society (particularly in terms of work), may constitute a challenge and a true problem for many households.

 

The Importance of Sleep in Child Development and Its Impact on Physical, Emotional and Cognitive Health

In childhood, sleep is of particular importance for physical, cognitive and emotional development.

On an organic level, sleep plays a role in regulating growth (through the secretion of growth hormone), in cerebral homeostasis (by eliminating metabolic by-products and selecting neuronal connections), cardiovascular risk (by reducing parameters according to sleep phases) and metabolic health (improved glycaemic profile and reduced risk of obesity). Associations have also been found between sleep deprivation and poor immune function.

Sleep also contributes to memory and learning consolidation. In cases of sleep deprivation and daytime sleepiness, a decline in cognitive abilities has been described, with lower academic performance, poorer short- and long-term memory, impulsivity, attention disorders and impaired language development. Its relationship with a child’s mood is also well documented (with an increase in negative or depressive emotions).

Sleep deprivation may compromise both organic and cognitive health, making it crucial to establish healthy sleep habits, with consistent routines and an appropriate environment, in order to safeguard the well-being of both child and family.

What is the Paediatric Sleep Consultation?

The Paediatric Sleep Consultation is designed to address any question or problem that parents — or the child, in the case of older children — may consider related to sleep. The approach takes into account the individuality of both child and family, aligning predictable and physiological aspects for each age group with the specific needs, concerns and expectations of the family.

It is aimed at patients aged 0 to 18 years and differs from a General Paediatrics consultation through its in-depth and exclusive focus on sleep, following protocols and guidelines based on the most up-to-date scientific knowledge of paediatric sleep medicine.
In general, families seek this consultation when they believe that their child’s sleep is negatively affecting their own well-being or the dynamics of the family. More specifically, when issues such as insomnia, night-time awakenings and fragmented sleep, delayed sleep onset, excessive or abnormal movements, excessive daytime sleepiness, sleep apnoea, concentration difficulties or behavioural changes are identified.

The First Consultation

Identifying the main concern as reported by the family
This step allows for a clear understanding of the family's specific concerns, ensuring that the therapeutic intervention is tailored to the child's actual needs and promotes better outcomes for their sleep and well-being.

Full clinical history
Including the child’s social context and family background;

Establishing the child’s chronotype
The times when the child's body 'prefers' to sleep, wake up, and be more active or alert.

Characterisation of the circadian period
Daytime (mealtimes, physical activity, screen use, light and sound exposure, family dynamics, naps) and night-time (rituals, routines, sleep characterisation);

Identification, therapeutic proposal and referral of medical problems
that may be causing sleep disturbances (e.g. atopic dermatitis, constipation, snoring, iron deficiency, among others);

Application of scales/questionnaires
According to age, such as the Brief Infant Sleep Questionnaire (BISQ), BEARS Sleep Screening Tool and the BRUNI Sleep Disturbance Scale for Children;

Provision of a sleep diary
To be completed at home (to support therapeutic intervention).

Initial therapeutic plan 

Once the problem is identified and characterised, an initial therapeutic plan is proposed, including optimisation of biological, social and environmental factors appropriate to the child’s age, cognitive-behavioural strategies, and the possible initiation of treatment if a medical condition affecting sleep is detected.

When necessary, referral and collaboration with other specialties may be recommended, such as ENT, dentistry, immunoallergology or paediatric neurology. Depending on the case, complementary assessments may be requested, including blood tests, imaging (e.g. adenoids, orthopantomogram), actigraphy or polysomnography (for older children).

In follow-up consultations, the child’s response to measures and medication is assessed, additional measures are reinforced, and therapy may be directed at the identified organic condition. In selected cases, sleep-inducing medication, such as melatonin, may be introduced.

Benefits of the Paediatric Sleep Consultation

By promoting sleep that is structurally appropriate to the child’s age, the consultation provides a wide range of benefits for both child and family.

For the child, improvements are observed in behaviour and emotional regulation (less agitation and impulsivity, reduced aggression or negative mood), optimised cognitive development, and enhanced learning and school performance. Biologically, benefits are noted in endocrine function (growth potential, appropriate circadian hormonal fluctuation), metabolism, cardiovascular health and, according to recent studies, even immunity.

For the family, there is less stress associated with parenting and social/work demands, greater mental availability for children and, consequently, a stronger parent-child bond. Families also report better time management and an improved ability to face the challenges of parenting.

The Paediatric Sleep Consultation is therefore of great importance for the physical, cognitive and emotional development of the child, while also improving the quality of family life. Identifying and treating sleep disorders helps to prevent problems such as learning difficulties, mood and behavioural changes, and even the development of chronic diseases, ensuring healthy growth and well-being for both child and family.